Avery, Samantha R
Avery, Samantha R is an individual health care provider with primary practice located at 1615 Pasadena Ave S Ste 300 , South Pasadena FL 33707-4567. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is her primary health care specialty. Avery, Samantha R can be contacted via phone (277) 490-3030.Contact Information
Primary practice address
1615 Pasadena Ave S Ste 300
South Pasadena FL 33707-4567
Phone: (277) 490-3030
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | OS 11371 | Florida |
Profile Details
| NPI number | 1215178090 |
|---|---|
| LBN Legal business name | Avery, Samantha R |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 9th, 2009 |
| Last updated | Jan 31st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215178090 | NPPES |
| Florida | Other | HT787Z | MEDICARE ID-TYPE UNSPECIFIED |
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